School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
PLoS One. 2021 May 27;16(5):e0251724. doi: 10.1371/journal.pone.0251724. eCollection 2021.
Current diagnostic criteria for posttraumatic stress disorder (PTSD) do not include symptoms resulting from exposure to continuous or ongoing traumatic stress. Thus existing assessment tools do not fully capture stress symptoms associated with exposure to threats that extend over months or years. To address this void, we enumerated the symptoms associate with ongoing exposure to stress including those that are distinct from existing PTSD diagnostic criteria.
To develop the Continuous Traumatic Stress Response Scale (CTSR) and assess its psychometric properties.
We sampled 313 adults exposed and unexposed to ongoing security threat between December 2016 and February 2017. Respondents lived in communities bordering the Gaza Strip in southern Israel where they are exposed to frequent rocket attacks, requiring they locate and find shelter in 30 seconds or less. We assessed the concurrent validity of CTSR relative to the Posttraumatic Diagnostic Scale (PDS).
On the basis of exploratory factor analysis (EFA), we retained 11 of 25 items measuring three distinct factors: exhaustion/detachment, rage/betrayal, and fear/helplessness. We found moderate concurrence between the scales; that is, the CTSR appears to measure a construct related to, but distinct from PTSD. This conclusion is supported by confirmatory factor analysis (CFA) indicating that each factor significantly contributes to measurement of a higher-order, continuous traumatic stress latent construct.
These results support the psychometric properties of CTSR. Future research is required to confirm these findings in other countries and cultures and among individuals exposed to other forms of continuous traumatic stress.
目前的创伤后应激障碍（PTSD）诊断标准不包括因暴露于持续或持续的创伤性应激而产生的症状。因此，现有的评估工具并不能完全捕捉到与暴露于持续数月或数年的威胁相关的应激症状。为了解决这一空白，我们列举了与持续暴露于应激相关的症状，包括与现有 PTSD 诊断标准不同的症状。
开发连续创伤应激反应量表（CTSR）并评估其心理测量特性。
我们在 2016 年 12 月至 2017 年 2 月期间对 313 名暴露于持续安全威胁和未暴露于持续安全威胁的成年人进行了抽样调查。受访者居住在以色列南部与加沙地带接壤的社区，他们经常遭受火箭袭击，需要在 30 秒或更短的时间内找到并找到避难所。我们评估了 CTSR 与创伤后诊断量表（PDS）的同时效度。
基于探索性因素分析（EFA），我们保留了 25 个项目中的 11 个，这些项目测量了三个不同的因素：疲惫/超脱、愤怒/背叛和恐惧/无助。我们发现两个量表之间存在中度一致性；也就是说，CTSR 似乎测量了一种与 PTSD 相关但不同的结构。这一结论得到了验证性因素分析（CFA）的支持，表明每个因素都显著有助于测量一个更高阶的、连续的创伤性应激潜在结构。
这些结果支持 CTSR 的心理测量特性。需要进一步的研究来确认这些发现是否适用于其他国家和文化以及暴露于其他形式的连续创伤性应激的个体。
